The Washington Post just published a story about the efforts brokers are making to protect the commissions they earn on health insurance.There are efforts in some states to mandate that individuals purchasing insurance through health care exchanges use a broker, which could easily add 5% or more to the cost of health insurance.There are 434,000 insurance brokers in the US – a potent political force.

There are efforts in some states to mandate that individuals purchasing insurance through health care exchanges use a broker, which could easily add 5% or more to the cost of health insurance.Brokers are seeking legislation to exclude broker commissions from the calculation of “medical loss ratio.”If this passes, the amount of premium that goes toward health care could be less than the 80-85% promised in the Affordable Care Act

Brokers are necessary when purchasing health insurance is complicated – and they can often help steer their clients away from bad deals, and help their clients find a policy that really meets their needs.

But that’s not the world of ideal exchanges.The state should structure the exchange so that offerings are highly standardized, and consumers should not need the assistance (and the cost) of a broker.

With each state creating its own health insurance exchange, there is huge opportunity to legislate extra steps and expense into health insurance purchasing.